The present invention relates to the field of psychological testing and more specifically to cognitive assessment of head injured patients, patients with neurological disorders, individuals suffering from psychiatric illnesses, and adults or children with learning disabilities. The present invention relates particularly to tests and tasks for assessment, training and remediation of grapho-motor abilities that according to the present art the examinee performs such tasks using conventional writing and drawing elements such as paper, pencils, pens, markers.
Various psychological tasks have been developed for both diagnosis and remediation of skills required for performing grapho-motor tasks. In some common tasks the examinee is asked to copy simple or complex geometric figures or designs. Typical examples are the Rey Osterrieth Complex Figure1, the Clock Drawing Test2, the Army Tests3, and the Bender-Gestalt Visual Motor Test4, which are described in references 1 to 4, respectively. Some Mental Status Exams and the Wechsler Memory Scale5 also include tasks of copying simple geometric figures or designs. In many other tasks, examinees are asked to copy letters, words and short sentences. In the art, evaluation of the performance of the examinee is most often based on evaluating the end result of the tasks, that is, on how accurately the examinee was able to accomplish the task1, 2, 3, 4, 5, 6 in entirety. However, it is known that the process of copying complex figures or handwriting is also of considerable importance. The strategy, e.g. order, the examinee uses to accomplish a given complex task, and the way the examinee writes letters and sentences, are indicative of his cognitive abilities, learning deficits, and the source of his disabilities. Thus, various attempts to assess the process of performing tasks have been made. See reviews in references 7, 8, 9 and 21. These reviews indicate that initially, attention was focused on assessment of the qualitative features of the performance of tasks. Only recently, the significance and advantages of using what has been termed a Quantified Process Approach for characterizing and assessing the performance process became clear10, 11, 12, 13, 14.
It is also important to realize that methods for recording the process by which an examinee accomplishes a task should not affect the “ecological validity” of performing that task; namely the natural, life-like manner in which the examinee performs it15, 16.
As noted earlier, several methods have been developed for recording and subsequently evaluating the process by which an examinee performs grapho-motor tasks. These prior art methods are based on a variety of “pencil and paper” techniques for manually recording the observed process. References 14, 17 and 18 describe methods that use multiple colored pencils, lists or flowcharts. For example, each time the examinee copies an important element of a geometric pattern; the examiner gives him a different colored pencil or makes a mark in the list or flowchart.
Since the pace of performing graph-motor tasks is usually fast and since manual notation is relatively time consuming and often erroneous19, 20, these and similar recording methods fail to record all the features of the process by which an examinee performs such tasks20. Hence, some researchers opt to use video recording to document the how an examinee draws simple or complex figures21. Video recording is cumbersome, time consuming and does not resolve all the issues described above. In addition, the above-mentioned inherent shortcomings of the prior art recording methods and the absence of recording methods that overcome them make it very difficult to use statistical methods for correlating performance of subjects on tests with other cognitive abilities14. Consequently, the process by which an examinee performs grapho-motor tasks is rarely evaluated in clinical settings, such as hospitals.
It is pointed out that methods employing computer-based and multi-media methods for increasing the utility of psychological testing have been disclosed. See U.S. Pat. No. 5,961,332, U.S. Pat. No. 5,991,565 and U.S. Pat. No. 6,115,683. These methods, however, are not applicable for recording processes of performing grapho-motor tasks.
Other methods have been suggested whereby an examinee actually performs psychological tests on a graphic display of a computer-based system interface (e.g. monitors, touch screens): Representative disclosures are included in U.S. Pat. Nos. 5,211,564, 5,218,535, 5,326,270, 5,379,213, 5,565,316 and 6,030,226. Although such testing methods have considerable merit for testing the general population, they are not adequate for tests that require the use of a pencil and paper. In addition, they are not ecologically valid. U.S. Pat. No. 6,629,846 describes a method by which an examiner observes the examinee and the examiner clicks on buttons that appear on the screen of his computer and which relate to elements of complex figures or of multi-element tasks. The method of U.S. Pat. No. 6,629,846 allows for recording the process of copying well-defined discrete multi-element figures and makes it possible to score it in real time. However, the method of U.S. Pat. No. 6,629,846 cannot fully record drawing of curved configurations, e.g. drawing a face of a man, cursive letters, and many other pencil and paper tasks. Methods have also been disclosed for digitizing the drawing and writing of individuals using various input devices. See U.S. Pat. Nos. 6,703,570, and 6,300,580.
There is thus a need for, and it would be highly advantageous to have a method of recording and scoring the process of performing ecologically valid computerized psychological tests that include one or more grapho-motor tasks.
All references cited herein are included by reference for all purposes as if fully set forth herein.
The term “test” as used herein refers to a psychological test for assessment, training and remediation of grapho-motor abilities including one or more tasks performed by an examinee. The terms “test” and “task” are used herein interchangeably.
The term “pen” as use herein refers to an instrument used for writing and includes pencil, or stylus and is used as a conventional writing instrument although may include sensory apparatus and data transfer apparatus (e.g. cable) for transferring graphic information regarding motion, e.g. traces, of the pen along a writing surface.
The term “surface” or “writing surface” as used herein, includes conventional writing surfaces and may include sensory or storage apparatus for transferring or storing information regarding writing on the surface.
The term “examinee” as use herein refers to a subject that performs grapho-motor tasks for testing as well as for remediation and training.